Maaranen Päivi, Tanskanen Antti, Hintikka Jukka, Honkalampi Kirsi, Haatainen Kaisa, Koivumaa-Honkanen Heli, Viinamäki Heimo
Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Compr Psychiatry. 2008 May-Jun;49(3):269-74. doi: 10.1016/j.comppsych.2007.04.010. Epub 2008 Jan 9.
There have been no previous general population studies on the stability of dissociative symptoms. The aim of this study was to examine the course of and the changes in dissociative symptoms and factors associated with these changes during a 3-year follow-up of a Finnish general population sample.
The general population sample included a cohort of 1497 subjects. Dissociative symptoms were assessed with the Dissociative Experiences Scale (DES) and the DES-taxon (DES-T). Depressive symptoms and suicidal ideation were measured with the Beck Depression Inventory (BDI). The sample was categorized into low dissociators with DES scores less than 20 and high dissociators with DES scores of 20 or more.
At baseline, 98 subjects were high dissociators. On follow-up, 28 of them were still high dissociators, whereas among 70 subjects, the DES score declined below the cutoff score. During the follow-up period, 28 of 1399 subjects became new high dissociators, and constantly low dissociators consisted of 1371 of 1399 subjects. Dissociative taxon membership was detected in 39 subjects either at baseline or at follow-up, but only 4 of them met the criteria at both assessments. Stable high dissociation was associated with an increase in the BDI score on follow-up, baseline suicidal ideation, a younger age, a reduced working ability, and smoking. Risk factors for becoming a new high dissociator were an increase in the BDI score, a younger age at baseline, and a reduced working ability. Among the baseline high dissociators, recovery from high dissociation was associated with a decline in the BDI score at follow-up and with no suicidal thoughts, older age, and a good working ability at baseline.
Only a small proportion of the general population had constantly high levels of dissociative symptoms. The stability of dissociative taxon membership was weaker than the stability of the continuous variables of dissociation. The dissociative experiences had a tendency to change, and these changes were associated with changes in the BDI scores. Further studies are needed to reveal the factors associated with the changes in dissociative symptoms.
此前尚无关于分离性症状稳定性的一般人群研究。本研究的目的是在对芬兰一般人群样本进行3年随访期间，考察分离性症状的病程、变化以及与这些变化相关的因素。
一般人群样本包括1497名受试者组成的队列。使用分离体验量表（DES）和DES分类法（DES-T）评估分离性症状。用贝克抑郁量表（BDI）测量抑郁症状和自杀意念。样本被分为DES得分低于20的低分离者和DES得分20及以上的高分离者。
在基线时，98名受试者为高分离者。随访时，其中28人仍为高分离者，而在70名受试者中，DES得分降至临界值以下。在随访期间，1399名受试者中有28人成为新的高分离者，持续的低分离者包括1399名受试者中的1371人。在基线或随访时，39名受试者被检测出属于分离分类，但其中只有4人在两次评估中均符合标准。稳定的高分离与随访时BDI得分增加、基线自杀意念、年龄较小、工作能力下降和吸烟有关。成为新的高分离者的危险因素是BDI得分增加、基线年龄较小和工作能力下降。在基线高分离者中，从高分离状态恢复与随访时BDI得分下降以及无自杀念头、年龄较大和基线时工作能力良好有关。
一般人群中只有一小部分人持续存在高水平的分离性症状。分离分类成员身份的稳定性弱于分离连续变量的稳定性。分离体验有变化的趋势，这些变化与BDI得分的变化有关。需要进一步研究以揭示与分离性症状变化相关的因素。
